Education
In this Episode of our type 2 diabetes education series, we discuss pharmacologic management, focusing on first-line therapy. Metformin remains foundational unless contraindicated, thanks to its weight-neutrality, low hypoglycemia risk, and cardiovascular benefits. Recent advancements position SGLT2 inhibitors alongside metformin for patients with cardiovascular disease, heart failure, chronic kidney disease, or high cardiovascular risk. They offer glucose-lowering effects and improve cardiovascular and renal outcomes. Important considerations include titrating metformin to minimize side effects, understanding sick-day rules, and being aware of diabetic ketoacidosis symptoms. Rescue therapy with insulin or sulphonylurea is discussed for symptomatic hyperglycemia. Tune in for a detailed guide on modern first-line therapy for type 2 diabetes and prepare for our next episode on intensification strategies.
00:00 Introduction to Type 2 Diabetes Series
00:21 First-Line Therapy: Metformin
00:48 Emerging Front-Line Therapy: SGLT2 Inhibitors
01:18 Case Studies and Practical Applications
01:43 Managing Patients Who Cannot Tolerate Metformin
02:04 Important Considerations for SGLT2 Inhibitors
02:33 Clinical Example: Chronic Kidney Disease
03:00 Rescue Therapy for Symptomatic Hyperglycemia
03:21 Summary and Key Takeaways
04:15 Looking Ahead: Intensification of Therapy
04:35 Conclusion and Next Steps